title: Immediate active range of motion after modified 2-incision repair in acute distal biceps tendon rupture.
abstract: BACKGROUND
  Different rehabilitation protocols have been used after repair of distal biceps ruptures.
  
  
  OBJECTIVE
  This study investigates the safety of immediate active range of motion protocol after modified 2-incision distal biceps tendon repair in acute ruptures.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Twenty-one patients with a minimum follow-up of 2 years were participants in this study. After repair, the upper extremities were placed in a sling for 1 to 2 days and then immediate active range of motion was started. For the first 6 weeks, the elbow was allowed activities of daily living as tolerated by the patient with a 1-lb weight-lifting restriction. Elbow range of motion, isometric and dynamic flexion, and supination strengths were recorded and Disabilities of the Arm, Shoulder and Hand (DASH) scores were obtained.
  
  
  RESULTS
  Mean follow-up extension was 0 degrees and mean follow-up flexion was 141 degrees on the operated side, with supination of 74 degrees and pronation of 75 degrees. The mean DASH score for 21 patients was 3.6 +/- 3.6 (range, 0-11.4). The mean follow-up isometric flexion strength was found to be 5% (P = .411), and the power (dynamic strength) of flexion was 12% greater on the operated side (P = .046). However, follow-up isometric supination strength was 9% less on the involved side than on the noninvolved side (P = .030), and the power of supination was 11% less on the operated side (P = .007). There were no tendon reruptures at follow-up, determined by physical examination.
  
  
  CONCLUSIONS
  A modified 2-incision distal biceps repair allows a safe immediate active range of motion protocol with early return of nearly full range of motion and strength, without any clinically significant disability.
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Akin
authors.initials: A
authors.lastname: Cil
authors.forename: Sheri
authors.initials: S
authors.lastname: Merten
authors.forename: Scott P
authors.initials: SP
authors.lastname: Steinmann
mesh_terms: D000328:Adult; D000368:Aged; D004551:Elbow Joint / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D012421:Rupture / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome; D000092464:Elbow Injuries